Preoperative Diagnosis Of Thyroid Cancer Research Articles

Evaluation of ultrasound-guided fine-needle aspiration biopsy for thyroid nodules

background We retrospectively studied whether ultrasound-guided fine-needle aspiration biopsy (US-FNAB) showed improved sensitivity in patients with palpable thyroid nodules. methods: A total of 70 patients (72 lesions) with thyroid nodules underwent US-FNAB and 94 patients (94 lesions) underwent FNAB guided by manual palpation (standard FNAB). The diagnoses obtained by US-FNAB were compared with the surgical findings. results The sensitivity of US-FNAB for palpable thyroid nodules was 62% the specificity was 74% the accuracy was 68% the positive predictive value was 100%, the negative predictive value was 70% and the inadequate biopsy rate was 17%. In contrast, the sensitivity of standard FNAB was 45%, the specificity was 51%, the accuracy was 48% the positive predictive value was 96, the negative predictive value was 55, and the inadequate biopsy rate was 30%. The accuracy of US-FNAB was significantly higher than that of standard FNAB. For tumors ≤2 cm in diameter, the sensitivity and accuracy of USFNAB were both significantly higher than those of standard FNAB. conclusion These findings suggest that USFNAB can improve the preoperative diagnosis of thyroid cancer, especially in patients with tumors ≤2 cm in diameter.

APPRAISAL OF FINE-NEEDLE ASPIRATION CYTOLOGY IN THE DIAGNOSIS OF THYROID CANCER

The efficacy of fine-needle aspiration cytology (FNA) in the preoperative diagnosis of thyroid cancer was investigated. The subjects were 1540 patients with thyroid nodule in whom FNA was performed and in whom the histological diagnosis was obtained between 1975 and 1992. There were 580 thyroid carcinomas, 943 benign tumors and 17 cases of Hashimoto's diseases. The diagnostic value of FNA showed a sensitivity of 85%, specificity of 93% and accuracy of 90%. The rate of accuracy was higher in papillary carcinoma (90%), and lower in follicular carcinoma (60%). Moreover, it was higher in small carcinomas of 1.0 cm or less (89%). The false-positive rate was higher in Hashimoto's disease. FNA was more accurate than palpation and ultrasonography for the preoperative diagnosis of thyroid cancer. FNA is a more useful and reliable for benign or malignant diagnosis, small cancer and information on histological types. FNA should be used for the initial diagnosis of thyroid nodules.